The experience of buying supplements in a health food store can be daunting! Multiple companies sell similar or identical vitamins, herbs and other supplements, and choosing one can seem like a Herculean task if you don’t come armed with some specific information. When I prescribe or recommend supplements, I give patients very detailed information on exactly what to buy, often including a few specific brand names that provide the quality and dose I recommend but are more flexible in price.
Labeling requirements for companies that make vitamins, herbs and supplements are regulated by the U.S. government, in the form of the Dietary Supplements and Health Education (DSHEA) Act of 1994, and overseen by the FDA. Companies are not allowed to make explicit claims about how the contents in the bottle may play a role in preventing or treating a medical condition. They can, however, put information on a bottle about the function of a product in the body (ie: “helps maintain healthy intestinal flora”) or how it may affect the structure of the body (“assists in lubricating joints”). These are called “structure/function claims”. The Federal Drug Administration is responsible for stepping in and enforcing the DSHEA rules if a company strays from the requirements.
Despite these rules, what is advertised on the front of the label may not necessarily be the whole truth for what is truly in the bottle. I was reminded of this the other day when looking at a calcium supplement bottle brought in by a patient. The front of the label advertised this as a calcium/magnesium supplement; the Supplement Facts label on the back told a different story! Included in the product were turmeric, ginger, horsetail, spirulina and willow bark. While these unexpected additions may be fine for some people, they could potentially increase the possibility of bleeding risk in other patients on certain medications. Of note, there was no warning on the bottle for consumers about potential herb/drug/supplement interaction risks.
While the DSHEA rule protects our very important freedom to obtain herbs, vitamins and supplements “over the counter” and without a doctor’s prescription, it also heightens the responsibility of the consumer to make sure what they decide to buy/take is both safe and appropriate for their individual medical condition(s) and needs. Just because something is “natural” does not mean it is safe or won’t interact with medications. In my practice, I check for both supplement/herb/vitamin and drug interactions as well as have detailed knowledge and information about potential interactions with medical conditions. Always “play it safe” and check with your healthcare professional and/or pharmacist before starting any type of supplements.
Danna Park, MD
Danna Park, MD, FAAP, FACP
Mountain Integrative Medicine, PLLC
138 Charlotte Street, Suite 203
Asheville, NC 28801
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